Free Gracilis Transfer in Children Improves Smile

Free gracilis muscle excursion in children has lower failure rates than in adults

WEDNESDAY, May 18 (HealthDay News) -- Dynamic facial reanimation using free gracilis transfer in children has an acceptable success rate, significantly improves smile, and may improve quality of life (QOL) with respect to facial function, according to a study published in the May/June issue of the Archives of Facial Plastic Surgery.

Tessa A. Hadlock, M.D., from the Massachusetts Eye and Ear Infirmary in Boston, and colleagues measured the gracilis muscle excursion and QOL changes in 17 pediatric patients undergoing 19 pediatric free gracilis transplantation operations. They were compared with excursion measured similarly in 17 adults undergoing 19 free gracilis operations. The children's QOL outcomes (functional outcomes) were evaluated using Facial Clinimetric Evaluation instrumentation.

The investigators found that pediatric free gracilis recipients had an average gracilis excursion of 8.8 mm, which matched that of adults, but with fewer complete failures of less than 2-mm excursion (11 percent in children and 21 percent in adults). Statistically significant improvements following dynamic smile reanimation were noted on QOL measures.

"Free gracilis transfer for smile reanimation in children carries an acceptable failure rate, significantly improves smiling, and seems to improve QOL with respect to facial function," the authors write. "Because it carries a lower failure rate than a similar cohort of adult patients, there is no need to wait until patients reach adulthood to offer dynamic reanimation."

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